Individual
MR. RUDY JOHN HERNANDEZ JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
PO BOX 1382, CRESTLINE, CA 92325-1382
(951) 544-0200
Mailing address
PO BOX 1382, CRESTLINE, CA 92325-1382
(951) 544-0200
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
95044697
CA
Other
Enumeration date
05/08/2024
Last updated
05/08/2024
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